Sw Center for Public Health Preparedness Grant Project Plan

SW CENTER FOR PUBLIC HEALTH PREPAREDNESS GRANT PROJECT PLAN "HOW TO ENGAGE COMMUNITY RESPONSE CORPS VOLUNTEERS" Very clear menu approach Work plan detailed with check offs

Medical Reserve Corps Project Overview: A MRC unit is a community based, organized group of volunteers who can serve during a local emergency health situation and assist with local public health needs. This project will provide well-trained, readily available pool of volunteers who know their locality and can help during the critical time when outside help may not have yet arrived. Volunteers will have the appropriate health care experience and training in order to work together effectively as a team. Through this project 4 pilot MRC units situated within four regions of Colorado will implement a community based MRC unit comprised of currently practicing and retired medical volunteers. The Colorado Nurse Alert System (CNAS) will play an oversight and general guidance role for the grant project and program coordinator. This council brings together state-wide agencies including volunteers and first responders including: American Red Cross, Area Health Education Centers, Colorado Board of Nursing, Colorado Department of Public Health and Environment, Colorado Health and Hospital Association, Colorado Nurses Association, Hospital Preparedness Program, and visiting Nurses Association. The primary objectives of the council is to provide:

1 Community representation to lead project coordinator.

2 Insight into Match the needs of first responders with the skills and abilities of volunteers to make their families, their homes, and their communities safer from the threats of terrorism, crime, and disasters.

3 Spearhead efforts to offer medical professionals both working or retired new and existing volunteer opportunities, educational information, and training courses to address crime, terrorism, and natural disaster risks.

4 Promote all MRC unit programs and activities across the state..

5 Capture innovative practices and report accomplishments that can be replicated in other communities nationally.

6 Project coordinator will survey the community to assess increased awareness and Citizen Corps participation. Problem: Public Health agencies have identified a need for organized volunteer surge capacity in times of emergencies/disasters in their jurisdictions. SW CENTER FOR PUBLIC HEALTH PREPAREDNESS GRANT PROJECT PLAN "HOW TO ENGAGE COMMUNITY RESPONSE CORPS VOLUNTEERS" Very clear menu approach Work plan detailed with check offs Goal: Implementation of a ready, willing and able MRC (MRC) team at the local community level who could serve as models for building response teams in statewide regional locations. The team will have training, exercises, drills, and common identification.

Purpose: To train medical volunteers on a community wide public health response to "all hazards" which include wild fire, pandemic influenza, health promotion, bio-terrorism and weapons of mass destruction.

Deliverables: The project will produce a project plan, a model notebook with table of content and supporting chapters emphasizing the project framework. Four pilot MRC will be implemented in four regions of Colorado. Objective How Key Activities Timeline Outcome Create conceptual Interview and research model Convene Steering Before October 1, 3 month planning model framework for Karen O’Brien committee 2004 9 month implementation 4 region county pilot Anne Watson “Colorado Nurse Ongoing evaluation . Objectives Medical Response Teams Alert System” to Project Plan Notebook . Timelines BT trainer & planner oversee the . Outcomes Salvation Army program Red Cross coordinator and Other volunteer agencies project. Enroll 4 pilot sites to Karen O’Brien to recruit pilot sites Recruit pilot sites. Representation of 4 establish an Close coordination is needed between Local agencies to regions NW, SE, SW, organized local MRC unit and those organizations designate lead Metro that will be collaborative that will use its local medical and agency coordinator. implemented during grant community-based public health volunteers with Project team approach to specialty skills. Coordinator will develop a volunteer interface with pilot MRC unit designated lead coordinator Objective How Key Activities Timeline Outcome Create job Define requirements from business Draft sent to September 15, 2004 Job description description, role and plan and scope of work. Steering Recruit & Interview responsibilities for These primary tasks are: Committee Hire 0.5 FTE by 0.5 FTE project Work with MRC unit planner to 10/15/2004 coordinator to work understand risks, resources, & needs as a resource & Establish & communicate best liaison between the practice approaches and resources council and the pilot Identify development resources for MRC unit planners volunteers and activities during non- and trainers crisis periods Define professional Volunteer Standards Each volunteer role November 1, 2004 Organizational chart volunteer role Who can volunteer? to have defined Volunteer standards & Identification operational & competencies Volunteer Competencies, orientation, development plan. Orientation model Activation, Communication, Cross discipline Assignments roles and responsibilities defined Define development Define priorities, duties & scope, Obtain Larry December 31, 2004 Measurable Timeline plan for volunteers competencies, team structure, and Chinowith NW & W Obtain local development teambuilding strategies regional workforce plan & needs assessment Identification, incident command, be survey defined Develop broad guidelines prepared and ready, knowing the what’s needed for Water safety, other players and roles, and cross discipline 16 Mental Health, emergency response plan and counties Legal aspects/Liability, & activation system Recruitment & retention plan of volunteers Mutual aid agreement Objective How Key Activities Timeline Outcome Create online www.cdphe.state.co.us/as/ollhom.asp Research all December 31, 2004 User friendly web site for resource file for Education and training resource information & possible websites volunteers volunteers registration forms- Office of Local Liaison Integrate user www.medicalreservecorps.gov houses all friendly web sites the locally established MRC unit contact info Implementation Systematic process of checklists for Establish guidelines January 1, 2005 4 pilot MRC units will MRC team lead to begin recruitment Recruit/screen/ initiate process Orient volunteers Establish a Interact pilot MRC units, project Conference calls January 31, 2004 and Share best practices communications coordinator, and agencies assisting in with pilot volunteer ongoing Online chat room strategy recruitment, and internal external coordinators operations. Develop pilot portal site Evaluation Quarterly reports Define measurable Ongoing monthly Share lessons learned outcomes and progress reports with standards and timelines Final Report 2004 deliverables 4 pilot sites established & address sustainability Sustainability Project coordinator to research August 2005 Pilot sites have future funding sources. sustainability plan Model produced to replicate in other established regions, & states in SW region. Goal 1: Create conceptual model framework for grant project to include objectives, timelines and outcomes. Conduct online research and interview key resources Karen O’Brien, Anne Watson (Thursday 9/10/04), Medical Response Teams, BT trainer & planner, Greg Schlosser Co.train.

Gather Steering committee “Colorado Nurse Alert System” to oversee the program coordinator and project. Key project director is Karen O’Brien

Establish key work plan as a detailed menu approach with specific tasks, to do check offs, milestones and timelines to be completed during project before October 1, 2004. It is estimated that the project will consist of a 3-month planning design, 9-month implementation, and ongoing evaluation.

Goal 2: Enroll 4 county pilots in 4 regions in Colorado. Enroll 4 pilot sites to establish an organized local collaborative community-based team approach to develop a volunteer MRC unit. Karen O’Brien to initiate recruitment and selection. Close coordination is needed between MRC unit and those organizations that will use its local medical and public health volunteers with specialty skills. The local pilot agencies will designate a lead MRC unit contact. Project Coordinator will interface with designated pilot agency contact.

Projected pilot sites representing 4 regions to be implemented include NW, SW, SE, and Metro.

Goal 2: Hire a Project Coordinator to interface with local MRC Unit coordinators and who reports to the coordinating council. Create job description, role and responsibilities for 0.5 FTE project coordinator to work as a resource & liaison between the coordinating steering committee and the pilot agency contact. Define requirements from business plan and scope of work. These primary tasks are: . Work with pilot agency contact to understand risks, resources, & needs . Establish & communicate best practice approaches and resources . Identify development resources for volunteers and activities during non-crisis periods Draft job description to be approved by Steering Committee by September 30, 2004

Plan to recruit, interview and select 0.5 FTE before 10/15/2004 Goal 3: Define professional volunteer role, recruitment, retention, and selection systems. Define scope of work for professional volunteers in order to clarify the scope of medical professionals essential. Emphasis will be placed upon systems to recruit, interview and screen, train and qualify volunteers, retain volunteers, and advocate for volunteers.

Develop Volunteer Standards defining, who can volunteer, identification, Volunteer Competencies, orientation, Activation, Communication, Assignments. Each professional volunteer group will have defined role, orientation, and development plan. Cross discipline roles and responsibilities defined in Organizational chart. Ongoing systems will support developing volunteer relationships and capabilities.

Develop an initial recruitment plan to invite healthcare professional such as physicians, dentists, nurses, pharmacists, mental health professionals and veterinarians to join the MRC. Develop role descriptions and scope of practice definitions for volunteers. Develop competencies, orientation, and training development plans for newly recruited volunteers.

Develop an application and qualification process to obtain, update and retain documentation of health professional licensure credentials and criminal background check from each MRC member recruited. The project coordinator will develop a guide to assist the pilot project in recruitment of MRC volunteers. This will include key elements of selection, interviewing, screening, and credentialing. Enrollment guidelines will include future workforce development recruitment and retention strategies that focus on youth, student health professionals & retired senior volunteer partners The project coordinator will assist the pilot MRC coordinators in establishing internal organization especially in tracking credentials and key information. The project coordinator will assist the MRC coordinator in establishing strategic planning, guidelines, policies, and procedures especially related to priority items such as identification cards, crisis communications, and incident report debrief.

Goal 4: Define development plan for MRC volunteers. Define priorities, duties & scope, competencies, team structure, and team building strategies.

Provide content resources to assure competencies in priority must know topics for orientation to include: disaster training, communication, understanding the incident command system, response system, disaster triage, mental health training, Critical Incident Stress Debriefing Teams, animal and livestock awareness, bio-terrorism agents, chemical agents and epidemiological investigation.

Provide information on available continuing education and training programs relevant to public health and disaster medical response. Goal 5: Implement, Evaluate, and sustain pilot projects within 4 counties within 4 regions of Colorado. Develop standard operating procedures (SOP) with guidance procedures to make pilot MRC units operational allowing MRC volunteers to augment local first responder agencies during disaster training and response. These procedures will include a communication and emergency notification plan in order to inform or mobilize MRC members. Established guidelines will also address liability and malpractice coverage for MRC volunteers during training and response, integration of recently retired healthcare professionals who no longer have an active license or prescribing privileges.

Pilot MRC units will be integrated into its local county and city emergency management and response plan as well as county health department contingency plans for immunization clinics and other local community needs. Overall MRC volunteers will help to meet the public health needs of the community throughout the year or in the event of a public health emergency.

MRC volunteers will partake in specific planning process to operationally integrate MRC into tabletop drills, field disaster exercises and actual response within each pilot county.

Sustainability will be addressed at each local pilot project as well as best practices shared for future integration of the MRC into formal state plans and legislation. Identify funding mechanisms to support volunteer recruitment, and retention strategies. VOLUNTEER STANDARDS All MRC volunteers must have appropriate education, training, and experience. All members of an MRC unit do not need the same education and training, although there are some common elements. When recruiting for an MRC unit, volunteers must be asked to show proof of their qualifications, including education, and work experience diplomas, current or past certifications and licensure. This requirement includes those volunteers who perform numerous functions that do not involve direct patient/victim medical care. At a minimum, it is recommended that MRC members have the following current skills: 1 Basic Life Support and Cardiopulmonary Resuscitation (CPR), consistent with the standards of the American Heart Association, American Red Cross or another recognized organization. 2 Basic first aid skills to deal wit shock, allergic reactions, bleeding, broken bones, burns, chemical splashes, chocking, eye injuries, skin wounds, dislocations, head trauma, heat exhaustion and stroke, poisoning, etc. MRC unit leaders should have a training plan for ensuring that volunteers who are accepted receive the training described above. The skills listed below are strongly encouraged for inclusion in an MRC unit. Not all members of the unit may need each of these skills. There should be a balance of skills in order to achieve the maximum possible effectiveness of the MRC unit as a whole. 1 Disaster response planning 2 Knowledge of local, regional and statewide emergency response capabilities 3 Knowledge of the mechanics of Disaster Medical Assistance Teams (DMAT) and epidemiological surveillance teams Program Coordinator Must have: . Experience building emergency response teams to assist local public health agencies in the development of trained volunteers. . Ideal if attended NMRC conference and training, or able to meet with someone how did attend. . Medical background RN preferred . Disaster response planning . Knowledge of local, regional and statewide emergency response capabilities . Knowledge of the mechanics of Disaster Medical Assistance Teams (DMAT) and epidemiological surveillance teams . Should be able to formulate a business plan with objectives, action steps, a timeline, and resources to achieve the plan. . People skills to link community resources and needs. . Be able to communicate effectively both verbal, written, and oral. Skills include ability to document unit achievements, write reports and grants. . Mentor and develop others.

Job Scope: . To meet with local medical response teams . Choose 4 communities in 4 emergency response regions as pilot sites . Use the National MRC as a standardized model to train volunteers . Provide recommendations to local public health . Assist local entities in the use of standardized training modules for medical volunteers . Build on the 8,000 RNs registered as medical response volunteers . Collaborate with regional BT planners, epidemiologists, and trainers through regular conference calls, and meetings (how often and outcomes of meetings to be defined. . E-train portfolio development

Job Summary: Provides consultation and expertise to the 4 pilot volunteer medical response team staff support, coordinates the activities associated with development of volunteer medical response BT teams; provides program support to internal group members to assist in distinguishing difference between paid and volunteer operations. The project coordinator will be able to formulate a business plan with objectives, action steps, a timeline, and resources to achieve the plan. Be able to link community resources and needs. Be able to communicate effectively both verbal, written, and oral. Mentor others. Document unit achievements and write reports. The project coordinator will share best practices between the pilot sites to recruit volunteers. Emphasis will be placed upon systems to recruit, interview and screen, train and qualify volunteers, retain volunteers, and advocate for volunteers. The project coordinator will develop a guide to assist the pilot project in recruitment of MRC volunteers. This will include key elements of selection, interviewing, screening, and credentialing. The project coordinator will assist the pilot MRC coordinators in establishing internal organization especially in tracking credentials and key information. The project coordinator will assist the MRC coordinator in establishing strategic planning, guidelines, policies, and procedures especially related to priority items such as identification cards, crisis communications, and incident report debriefing

Responsibilities: Directs and coordinates activities concerned with implementation of objectives of grant project. Responsibly of this position include the planning, execution and evaluation of project. Ensures integration of project with overall program initiatives. Collects and analyzes data, identifies areas of need and/or improvement, and develops recommendations for program improvement. Develops reports on project status and issues for management review. Position will act as a liaison with 4 pilot sites, local communities and other organizations. Provides program development and technical support for coordinator of volunteer medical response teams; implements a knowledge based system for sharing ideas, best practices and innovations between coordinators of pilot volunteer medical response teams, actively seeks out and assigns mentors to broaden organizational knowledge and actively engage volunteers in relief activities.

The project coordinator will develop an initial recruitment plan to invite healthcare professional such as physicians, dentists, nurses, pharmacists, mental health professionals and veterinarians to join the MRC. A system will be developed to share best practices between the pilot sites to recruit and retain volunteers while developing supporting systems to recruit, interview, screen, train and qualify volunteers, credentialing verification, retain volunteers, and advocate for volunteers. Develop role descriptions and scope of practice definitions for volunteers. Develop competencies, orientation, and training development plans for newly recruited volunteers. The project coordinator will assist the pilot MRC coordinators in establishing internal organization especially in tracking applications, licensure credentials, criminal background check and key information from each MRC member recruited. Position will provide guidance to assist the MRC coordinator in establishing strategic planning, guidelines, policies, and procedures especially related to priority items such as identification cards, crisis communications, and incident report debriefing.

This position will work as a liaison between the council and the pilot MRC unit coordinators. The project coordinator will be a resource to assist MRC coordinator to develop a community network of response partners who are responsible to handle external coordination activities and the organizational tasks. These primary tasks are: . Work with response partners to understand risks, resources, and needs . Communicate during and debriefing after an incident or other utilization of volunteers. . Identify activities for volunteers during non-crisis periods.

Qualifications: Bachelor’s degree in health profession or public health administration. Desired experience includes community public health, first responder, project management, volunteer support, and leadership. May require Masters or other post-graduate education depending upon technical knowledge required to perform duties of specific position. Travel throughout Colorado with valid driver’s license and personal transportation. Talented individual capable of building relationships within both rural and urban pilot sites. Experience in human resource management and staff development a plus. The project coordinator will be able to formulate a business plan with objectives, action steps, a timeline, and resources to achieve the plan. Be able to link community resources and needs. Be able to communicate effectively both verbal, written, and oral. Mentor others. Document unit achievements and write reports.

Develop contact with healthcare professional organizations, independent practice associations, hospitals and clinics throughout Colorado pilot regions to initiate recruitment of medical and administrative support volunteer personnel to the MRC unit. MRC The first response to any emergency begins locally Overview A MRC unit is a community-based, organized group of volunteers who can serve during a local emergency health situation and assist with local public health needs. Volunteers should have the appropriate health care experience and training in order to work together effectively as a team.

Benefits to your community Major local emergencies can overwhelm the capacity of first responders, especially during the first 12 to 72 hours. Having citizens who are prepared to take care of themselves, their families and others during times of crisis will allow first-responders to focus their efforts on the most critical, life threatening situations. An organized, well-trained MRC unit means that volunteers can effectively respond to an emergency, are familiar with their community’s response plan, know what materials are available for their use, know who their partners in the response are, and know where their skills can be utilized to their best advantage and in a coordinated manner.

The local MRC unit is a valuable asset for helping to address public health concerns in a community throughout the year. Examples of activities might include: 1 Childhood immunization campaigns 2 Influenza shot campaigns 3 Health education, including nutrition and physical fitness for youth groups, faith-based groups and the elderly 4 Support to existing local public service organizations

An organized team approach During an emergency, a local government will activate its local emergency operation plan. These local plans define how the emergency personnel (fire, law enforcement, emergency medical) will respond to and manage the emergency. Spontaneous volunteers may hinder rescue efforts because they may not be familiar with local plans or procedures.

By creating a MRC unit that is linked to a local government’s emergency operations plan, the members of the MRC unit can truly benefit the community by knowing what their role is during the emergency, how they fit into the local emergency plan, and how best to respond so that they are a positive support structure for the first responders. Considerations for planning an MRC Unit A community’s geographical vulnerabilities (.g., earthquake zone, coastal lowland area, presence of a large chemical or nuclear plant) will influence local decisions about MRC unit needs. Local officials should think about what the community will require of a MC, taking into account existing health and related resources and their current organization. Planners of an MRC unit should talk with community leaders (e.g. the local government, civic organizations, health professional organizations, citizen groups, etc.) about public health needs, and gaps that members of an MRC unit could fill. An important principle for such a plan is that an MRC unit should not replace or displace existing resources and capacities; it is only a supplement to existing ones.

Getting Started The role Risks and vulnerabilities Planning a Medical reserves Corps Local planners should consider the following questions as they prepare to form a MRC unit. This list is not meant to be complete, but does provide the outline of factors that should be considered prior to forming an MRC unit. 1 What is the relationship between the MRC unit and local government? 2 What are the roles of various local institution-hospitals, schools, places of worship, and workplaces in the event of an emergency? 3 What would be the best organizational structure, including lines of command and accountability? 4 Does our community have potential volunteers available or should we join forces with a nearby town or city? 5 What equipment is needed? 6 How can the community supply and support volunteers during an emergency (e.g. food, water, transportation, clothing, shelter)? 7 Who can be enlisted to undertake a review of liability and legal issues (e.g. a local law firm, legal counsels in the Mayor’s office or local bar association)? 8 Who will lead the MRC unit? 9 Once organized, how can the MRC unit best maintain its readiness? 10 How will volunteers be assigned during an emergency? 11 What are the community’s existing resources, including volunteers, organizations and institutions that currently address public health and emergency response needs? 12 What is the relationship between the existing health organizations and MRC volunteers? 13 How can we build upon already-existing emergency plans? 14 What are the roles of various local institutions –hospitals, schools, places of worship, and workplaces-in the event of an emergency? 15 What are my community’s risks and vulnerabilities (e.g. floods, tornadoes, hurricanes, presence of chemical or nuclear industry)? 16 How can the MRC unit be sure to address any special needs, such as those of elderly persons, children and persons with disabilities? 17 Will interpreter services be needed? 18 How can the MRC unit contribute to the overall health and well being of the community? 19 How can volunteers be used in public hospitals, community health centers or otherwise to meet local health needs and priorities when there is not an emergency? 20 What organizations can help the community develop a MRC unit? 21 How can we recruit volunteers and raise public awareness about the MRC unit? 22 What specific training is needed and who will provide it? 23 What training resources are available or needed? 24 What procedures will be put in place to protect volunteers? 25 How will the community raise the money to purchase additional equipment, training, and supplies?

Funding 1 Volunteer time is generally uncompensated. However volunteers do need supplies and other support, including: 2 Education and training 3 Protective equipment and clothing 4 Supplies (gloves, syringes, splints, etc) 5 Food and shelter 6 Communication equipment (cell hones, computers, etc)

Volunteer Standards Who can volunteer? Identification Volunteer Assignments Managing a local MRC Chain of command Accountability and Reporting Developing an action plan Management structure Local resources Non-governmental organizations Evaluation

Legal considerations Licensure and Certification Legal and liability issues Liability of healthcare personnel Non-medical liability Worker’s compensation Provider credentials

Education and training Volunteer safety maintaining readiness Maintaining readiness

Opportunities for program linkages Metropolitan medical response system Commission corps readiness force Bioterrorism health preparedness and response Bioterrorism hospital preparedness and Response National Pharmaceutical Stockpile